Caristo AI Score Improves Heart Risk Prediction in 19,110

Oxford, England, United Kingdom, November 11, 2026

CaRi-Heart Technology Reveals Hidden Coronary Inflammation

CaRi-Heart is an artificial intelligence-powered cardiovascular imaging technology developed by Caristo Diagnostics, a University of Oxford spinout company. Its core biomarker, the Fat Attenuation Index (FAI) Score, measures changes in the characteristics of the fat surrounding coronary arteries, known as pericoronary adipose tissue (PCAT). When inflammation develops in coronary arteries, it can influence the biological characteristics of surrounding fat tissue. CaRi-Heart uses AI-based image analysis to identify these changes in routine coronary computed tomography angiography (CCTA) scans. The resulting FAI Score provides an assessment of coronary inflammation that can help clinicians understand cardiovascular risk beyond conventional measurements of plaque and calcium deposits. The newly published research evaluated the relationship between coronary inflammation and long-term cardiovascular outcomes. Researchers analyzed an independent validation population of 19,110 individuals, with a median follow-up period of 6.7 years. During follow-up, 536 cardiovascular deaths and 1,727 major adverse cardiovascular events were recorded. The findings demonstrated that coronary inflammation independently predicted cardiovascular mortality, even after accounting for coronary calcium levels and other established clinical risk factors. Importantly, adding FAI Score measurements to conventional calcium scoring improved cardiovascular risk discrimination, demonstrating the additional value of assessing inflammation alongside structural indicators of coronary artery disease.

High Cardiovascular Risk Identified Despite Zero Calcium

One of the most important findings involved patients with zero or minimal coronary artery calcium scores. Traditionally, a CAC score of zero is generally considered reassuring because it indicates the absence of detectable calcified plaque. However, the study demonstrated that a low calcium score does not necessarily exclude underlying coronary inflammation or future cardiovascular complications. According to the published findings, 42% of cardiovascular deaths and 51% of major adverse cardiovascular events occurred among individuals with CAC scores below 100. This highlights an important limitation of relying exclusively on calcium scoring to assess cardiovascular risk. The research also demonstrated that patients with very high coronary inflammation measurements could have substantially increased cardiovascular mortality risk despite having no detectable calcified plaque. According to Caristo’s reported analysis, individuals with very high inflammation assessments and a CAC score of zero had a 14.1-fold higher risk of cardiovascular death compared with the relevant low-inflammation reference group. Similarly, very high coronary inflammation in individuals without detectable calcified or non-calcified plaque was associated with a 10.4-fold higher cardiovascular mortality risk. Among patients with a CAC score of zero who subsequently died from cardiovascular causes, FAI-based assessment reclassified nearly half into high- or very-high-risk categories. These findings demonstrate why evaluating coronary inflammation could provide additional information for identifying patients whose cardiovascular risks might otherwise remain undetected.

Non-Contrast CT Research Expands Diagnostic Potential

Another significant development from the research is the investigation of whether coronary inflammation can be measured using non-contrast cardiac CT scans. Conventional FAI assessment through CaRi-Heart relies on contrast-enhanced coronary CT angiography. The research team developed and evaluated an additional AI-based approach capable of extracting inflammation-related information from non-contrast cardiac CT images commonly used for coronary calcium scoring. This development could potentially expand access to coronary inflammation assessment because non-contrast CT scans are widely used in cardiovascular risk evaluation. If further validated and authorized, the approach could enable clinicians to identify additional at-risk individuals without requiring a separate contrast-enhanced imaging examination. However, the application of FAI Score to non-contrast CT remains investigational and is not currently an approved commercial feature of CaRi-Heart. Professor Charalambos Antoniades, British Heart Foundation Chair of Cardiovascular Medicine at the University of Oxford and senior author of the study, emphasized the importance of understanding coronary inflammation alongside conventional measurements of plaque and calcium. Steve Deitsch, Chief Executive Officer of Caristo Diagnostics, highlighted the potential of AI-powered imaging to improve cardiovascular risk assessment and support more personalized preventive strategies. The latest publication represents an important milestone in AI-driven cardiovascular diagnostics and precision medicine. By identifying inflammatory risk that conventional imaging measurements may overlook, CaRi-Heart could help advance more comprehensive approaches to cardiovascular assessment. Further clinical research will be important to determine how inflammation-guided risk classification can influence treatment decisions and improve long-term patient outcomes.

Source: Caristo Diagnostics press release